Expansion of China's free antiretroviral treatment program / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>In 2003, China's National Free Antiretroviral Treatment Program (NFATP) was initiated as a pilot, which covered only 100 HIV/AIDS patients. By 2011, the pilot had evolved into a nationwide program and had provided free treatment for over 150 000 patients. The objective of this study was to report and evaluate the progress of China's free antiretroviral treatment program.</p><p><b>METHODS</b>The NFATP Database was systematically reviewed and a total of 150 692 HIV/AIDS patients were included in this study. Program progress indicators including the number of treated HIV/AIDS patients, follow-up visit rate, CD4 test rate, and viral load test rate were summarized and examined over a calendar year to evaluate the progress of NFATP quantitatively and qualitatively.</p><p><b>RESULTS</b>By the end of 2011, a total of 150 692 HIV/AIDS patients had been treated through the NFATP and 122 613 of them were still on treatment. Of all patients, about 72% were enrolled during the past four years. The dominant transmission route was blood related in the early phase of the NFATP, but gradually changed to sexual contact. Besides quantitative improvements, progress indicators also demonstrated significant qualitative improvements that the program had made during the past 9 years.</p><p><b>CONCLUSIONS</b>Great achievement has been made by China's NFATP. China's experience indicates the importance of a comprehensive response to the success of its treatment program. However, to ensure the quality and sustainability of treatment in the long term, more attention and resources should be paid towards program management.</p>

A retrospective cohort study on reduction of AIDS mortality among patients enrolled in national-free antiretroviral treatment programme in two cities in China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To determine the effect of national free highly active antiretroviral treatment (HAART) on reduction of mortality and relevant risk factors among adult Acquired immunodeficiency syndrome (AIDS) patients.</p><p><b>METHODS</b>A retrospective cohort study was conducted and all AIDS patients diagnosed before Aug. 30th, 2008 in Zhumadian, Henan province, and Fuyang, Anhui province were enrolled in this study, where HAART initiated in early time. The data and information were collected such as AIDS progress, diagnosis, treatment, death and et al.</p><p><b>RESULTS</b>Among 10,394 AIDS patients, the mean age was (41.7 +/- 9.3) year-old, 50.3% (5233/10,394) were male, 85.0% (8808/10,394) were married, 95.1% (9880/10,394) were farmers, and 81.2% (8438/10,394) were former plasma donors (FPDs). The coverage of HAART increased from 5.2% in 2002 to 66.5% in 2008. Conversely, the overall mortality declined from 35.4/100 person-years in 2002 to 5.9/100 person-years in 2008. In a multivariate Cox proportional hazards analysis, the greatest risk factor for mortality was non-HAART, with a hazard ratio (HR) 4.3 (95%CI: 4.0 - 4.7). Among treated patients, compared with higher CD(4)(+) T cell counts (> 200 cells/microl), those initiating therapy with lower CD(4)(+) T cell counts, were at greater risk to death (< 50 cells/microl, HR = 7.9; 50 - 199 cells/microl, HR = 2.8). Number of opportunistic infections (OIs) was risk to mortality (HR = 2.1). In addition, other risk factors included male, age (>or= 50 years old), and other infection way except FPDs (HR were 1.4, 1.6 and 1.8).</p><p><b>CONCLUSION</b>The national free treatment program has significantly reduced the AIDS mortality rate among HIV-infected FPDs through the use of generic antiretroviral drugs in rural clinical settings. The effective reduction of AIDS mortality could be realized through increased coverage of therapy.</p>

Study on the quality of life and influencing factors among people living with AIDS / 中华流行病学杂志

Objective Studing the main influencing risk factors to provide evidence for improving the quality of life among people living with HIV. Methods The quality of life on 758 patients with HIV was evaluated by the Medical Outcomes Study Short-Form Health Survey (SF-36) and some potential risk factors as personal characteristics and disease condition were studied. Means and standard deviations of data were calculated and differences among groups and variances were tested using Student's t test, followed by step-wise multivariate regression. Results The SF-36 two summary scores of 758 patients with HIV appeared to be 45.34±8.77 and 41.92±12.01 respectively. The physical component surmmary scores (PCS) had a gradual decrease with the increase of age. However, mental component summary scores (MCS) had a gradual decrease with the increase of time receiving the treatment. Male patients reported having a better quality of life (QOL) than female, and patients who were infected through injecting drug use and sexual transmission reported to have had better QOL than patients who were infected through paid blood plasma donation. Compare to patients having low CD4+ count, those having higher CD4+ count reported to have better QOL. Conclusion Patients being young, female, infected through paid blood plasma donation, having low CD4+ count, or treated for longer period, would have unsatisfactory QOL.

Step-test on surveillance of students' physical fitness and health / 中华预防医学杂志

<p><b>OBJECTIVE</b>To analyze the role of step-test on large sample surveillance in students' physical fitness and health.</p><p><b>METHODS</b>Totally, 36 237 students aged 12-, 14- and 17-year-old from fifteen Chinese provinces taking part in the 2004th National Surveillance on Students' Physical Fitness and Health were enrolled in this study. All of them passed through the step-test, of which the indices were calculated in combining with the performance time and pulse rates in resuming period. The means of step-test index were analyzed among various youth groups, and compared with the obesity, overweight and the normal-weight subjects.</p><p><b>RESULTS</b>As compared with the general level of physical growth, the means of step-test index were found higher in rural groups than in urban ones, and higher in southern groups than in northern ones. The highest means of index was found in the rural groups in having the lowest socioeconomic status, and also the lowest means found in metropolis groups having the highest socioeconomic status. These gaps were due to the change of life style, absence of physical exercise and relatively to the high body weight of the high socioeconomic-level groups. Among the obesity, overweight and normal-weight youths, the means of step-test index was shown in a gradient decrease tendency, and those significant gaps might be found between the obesity and the overweight, and the overweight and the normal-weight groups, showing that there should be harmful influences of overweight and obesity on the youth's cardiovascular function.</p><p><b>CONCLUSION</b>As a safe and easily-taken measure for cardiovascular function, the step-test should be useful in regularly measuring the national students' physical fitness and health status.</p>

Secular changes of physical growth in students of Zang-tribe in Tibet during 1965-2004 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To analyze the secular changes of physical growth in 7-17 year old students of Zang-tribe in Tibet during 1965-2004, and to make suggestions for further improvement.</p><p><b>METHODS</b>The data collected by local government in 1965 and Chinese national survey on students' physical fitness and health in 1985, 1995 and 2004 were used to analyze and find out the differences from the students' stature, body weight, chest girth, and BMI in different years, and to compare the increasing rate per 10 years in different periods of time.</p><p><b>RESULTS</b>Levels on stature, body weight and chest girth were increased significantly among 7-17 year-old students of Zang-tribe in Tibet during 1965-2004. From 1965 to 1985, the levels of stature and body weight were increased 11.4 cm and 5.0 kg respectively among male Zang-tribe students, 9.1 cm and 3.9 kg among the female. During 1985-2004, stature levels of Zang-tribe students was kept rising in much less extent, while average levels of body weight were reaching up remarkably, especially in 1995-2004, in which the average increasing rate per 10 years had achieved 14.8% and 13.4% among the male and female students aged 7-17 years old respectively. Levels of chest girth were increased rapidly in 1965-1985, showing a higher increasing rate in male students (2.7%) than in female students (1.9%). In 1985-2004, the increasing rates fell obviously both in male and female students, but there existed a higher rate in 1995-2004 than in 1995-1985, especially for females (4.0%). Upon the secular changes of stature and body weight, the levels of BMI were decreased in 1985 as comparing to those in 1965, then increased rapidly in 1985-2004, especially in 1995-2004, having an increasing rate up to 12.6% and 12.4% respectively in male and female students.</p><p><b>CONCLUSION</b>Secular changes on physical growth among 7-17 year-old students of Zang-tribe in Tibet were paralleled with the economic progress in 1965-2004, giving active effects by economic progress and nutrition improvements to the physical growth of children and adolescents.</p>

Analysis of motor performance status in students of Han nationality in fifteen provinces in China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To analyze the motor performance status in students of Han nationality in fifteen provinces in china.</p><p><b>METHODS</b>Totally, 161 804 students of Han nationality aged from 7 to 18 years old were involved in the Chinese Surveillance on Students' Physical Fitness and Health in 2004. Motor abilities were accessed with the aid of gripping power, 50 m dash, standing long jump, and 1-min sit-ups. Based on general statistical description, principal component analysis and linear regression, the development characters of students' motor performance were explored.</p><p><b>RESULTS</b>This research showed some characters similar to those of last ones: motor capability was improved in correlation with age; boys did better than girls, the difference between 18 year-old rural boys and rural girls was 15.3 kg, -2.0 s, 58.6 cm, 8.7/min; the urban students performed better than the rural ones, the difference between 15 year-old urban boys and rural boys was 0.9 kg, -0.2 s, 3.5 cm, 3.5/min. The first principal component might represent the 4 tests greatly. Regression analysis on principal component quantitatively interpreted the influence of factors such as age, sex and area.</p><p><b>CONCLUSIONS</b>The general principles of exercise quality development of students are still in work. Principal component analysis should be adequate and convenient in motor performance analysis.</p>